Marvin Keith Hendon, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY 3823 Issued in FL

Practice address

240 North Washington Boulevard
308
Sarasota, FL 34236

Phone

(941) 316-0230

Fax

(941) 316-0246

NPI assigned

Mar 19, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakewood Ranch Medical Center Hospital, Bradenton, FL, CCN 100299

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakewood Ranch Medical Center

  • General Acute Care Hospital
  • Bradenton, FL
  • NPI 1730179714
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962526780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NORTH WASHINGTON BOULEVARD",
            "address_2": "308",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34236",
            "telephone_number": "941-316-0230",
            "fax_number": "941-316-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 NORTH WASHINGTON BOULEVARD",
            "address_2": "308",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "34236",
            "telephone_number": "941-316-0230",
            "fax_number": "941-316-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDON",
        "first_name": "MARVIN",
        "middle_name": "KEITH",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY 3823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEECHSTREET",
            "identifier": "21263816879",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "503289",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "236417",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF FLORIDA",
            "identifier": "287365",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karen J Hemans, APRN
• Mina Hemmati, MD
• Blake Henderson, PHARMD
• Dinah E Henderson, APRN
• Ryan Kelly Henderson
• Phillip D Hendra, LMHC
• Leslie Hendricks
• Wesley Aaron Hendricks, DO
• Belle G. Heneberger, LMHC
• Stacey Suzanne Heney, L.M.T. N.M.T.

• Clinical Psychologist in Sarasota, FL
• Providers in Sarasota, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.